School of Kinesiology, Human Sensorimotor Control Laboratory, University of Minnesota, Minneapolis, MN, USA.
Department of Neuroscience, Istituto Superiore Di Sanità, Rome, Italy.
Neurol Sci. 2024 Oct;45(10):4847-4856. doi: 10.1007/s10072-024-07561-1. Epub 2024 May 11.
Pain is a common non-motor symptom in patients with cervical dystonia (CD), severely impacting their quality of life. The pathophysiology of CD is incompletely understood but it involves altered processing of proprioceptive and pain signals.
The purpose of this proof-of-concept study was to determine if vibro-tactile stimulation (VTS)-a non-invasive form of neuromodulation targeting the somatosensory system-can modulate neck pain in people with CD.
In a multi-center study, 44 CD patients received VTS to sternocleidomastoid and/or trapezius muscles for up to 45 min under 9 different stimulation conditions that either targeted a single or a pair of muscles. The primary outcome measure was a perceived pain score (PPS) rated by participants on a 100-point analogue scale.
During VTS, 29/44 (66%) of participants experienced a reduction in PPS of at least 10% with 17/44 (39%) reporting a reduction in pain of 50% or higher. After VTS cessation, 57% of participants still reported a 10% or higher reduction in PPS. Effects were significant at the group level and persisted for up to 20 min post-treatment. No distinct optimal stimulation profiles were identified for specific CD phenotypes. Clinical markers of disease severity or duration did not predict the degree of VTS-induced pain reduction.
This proof-of-concept study demonstrates the potential of VTS as a new non-invasive therapeutic option for treating neck pain associated with CD. Further research needs to delineate optimal dosage and long-term effects.
疼痛是颈肌张力障碍（CD）患者常见的非运动症状，严重影响其生活质量。CD 的病理生理学尚不完全清楚，但涉及到本体感觉和疼痛信号的改变处理。
本概念验证研究的目的是确定振动触觉刺激（VTS）-一种针对感觉系统的非侵入性神经调节形式-是否可以调节 CD 患者的颈部疼痛。
在一项多中心研究中，44 名 CD 患者接受 VTS 治疗，持续时间最长为 45 分钟，共 9 种不同的刺激条件，这些条件要么针对单一肌肉，要么针对一对肌肉。主要的结果衡量标准是参与者在 100 点模拟量表上评定的感知疼痛评分（PPS）。
在 VTS 期间，44 名参与者中有 29 名（66%）的 PPS 至少降低了 10%，其中 17 名（39%）的疼痛减轻了 50%或更高。VTS 停止后，57%的参与者仍报告 PPS 降低了 10%或更高。在群体水平上，效果显著，并持续到治疗后 20 分钟。对于特定的 CD 表型，没有确定明确的最佳刺激方案。疾病严重程度或持续时间的临床标志物不能预测 VTS 引起的疼痛减轻程度。
本概念验证研究证明了 VTS 作为一种新的非侵入性治疗选择，用于治疗与 CD 相关的颈部疼痛的潜力。需要进一步研究来描绘最佳剂量和长期效果。
